Sec VI: Abdomen

Question 1

Doom, Vet Surg 2016

• Describe the novel technique
• What did this study find?

Answer 1

• Lengthening omental pedicle flap technique in K9 cadavers based on splenic artery to preserve omental blood supply
• Superficial and Deep omental leaves were ea supplied by a L and R marginal omental a that anastomosed caudally into omental arches
• Intact omentum reached R axilla in 3 dogs, both axillae in 1 dog, and both groins in all dogs
• The omental pedicle reached to and beyond axilla and inguinal regions in all dogs
• By unfolding pedicle tip- width doubled.

Question 2

Rodriguez, Vet Surg 2018

• What did this study find in regards to the biomechanical properties of the feline ventral abdominal wall?

Answer 2

-The POU region achieved lower loads to failure.
- Load to failure was greater in males compared with females.
-No difference was detected between full-thickness
and fascia-only closure OR between Vicryl and PDS closure
-Failure most commonly occurred by tearing of suture through tissues.
-Tissue failure with suture line loosening occurred mainly in the 5 x 5-mmSBSI group.
- Thickness of linea alba decreased from cr to cd

Question 3

Rossanesse, JSAP 2019

What congenital condition may be predisposed in Cavalier King Charles Spaniels? And what did this study find?

Answer 3

• Congenital pleuroperitoneal diaphragmatic hernia (rare) caused by a defect in the dorsolateral diaphragm (L crus).
• The hernia configuration was consistent in all cases
• Defects of the L crus of the diaphragm –> herniation of the stomach into thorax w/ possible tension gastrothorax

Question 4

Matiasovic, JSAP 2018

• What was found with thoracic/abdominal wall impalement in 54 dogs?

Answer 4

• Impalement w/ wooden objects (n=34),
• Thoracic cavity was most commonly penetrated (n=37).
• CT: sensitive and specific to ID wooden material in 64% and 88% of 11 cases.
• Thoracotomy was performed in 56%, celiotomy in 20% and FB or its fragments were retrieved during Sx in 37% of cases.
• Complications occurred in 19 dogs (35%): 68% were minor and 32% major.
• Survival rate for thoracotomy cases was 93% (n=30).
• Overall long-term survival was 90%.

Question 5

Morgan, Vet Surg 2020

• What was found in this retrospective study of 128 dogs with PPDH diagnosed?

Answer 5

• 91 dogs tx w/ sx and 37 dogs conservatively
• Dogs treated surgically were younger, more likely to be sexually intact, more likely to have C/S from PPDH & more likely to have other congenital abnormalities compared with dogs treated conservatively.
• 97% of ST dogs were discharged from hospitals.
• Intraoperative and postop complications
  were reported in 22% and 41% of dogs; Most complications were low grade (75% and 83%)
• Followup was available in 87 dogs, at a median of 1062 days.
• Hernia recurrence was not reported.
• The deaths of 9 dogs (five ST, four CT) could be attributed to PPDH
• Long median survival times were observed
  in both the ST and CT groups (8.2 and 5 years).

Question 6

Barfield, JVECC 2016

What was found in regards to recurrent septic peritonitis in 41 dogs?

Answer 6

• There was no difference detected between survivors
  and nonsurvivors with recurrent peritonitis in terms of inciting cause, serum albumin concentration, surgical
  management, or provision of appropriate initial antimicrobials.
• Survival rate was 43.9% (18/41 dogs).
• No significant prognostic indicators for dogs with
  recurrent peritonitis and mortality rate (56.1%) for dogs having more than one surgery for septic peritonitis is
  similar to that reported for a single surgery.

Question 7

Spillebeen, Vet Surg 2017

• What was found in regards to treatment of septic peritonitis?

Answer 7

• Negative pressure abdominal drainage vs. passive
• Overall survival was 81%.
• Tx costs, Ax and operating time, drainage time, survival, and postop complications were similar between techniques.
• Loss of total plasma protein and decreased inflammation-related factors in abdominal fluid at time of closure were noted in all patients.
• Neutrophilic inflammation was greater in abdominal wall samples after NPAD.
• POAD patients showed discomfort during bandage changes and had frequent leakage of abdominal fluid outside of the bandage.
• NPAD resulted in less abdominal fluid leakage, and evidence of superior healing on histological evaluation of abdominal tissues.

Question 8

Fleming, Vet Surg 2018

• What’s the significance of spontaneous hemorrhage discussed in this paper?

Answer 8

• Splenic hemorrhage was diagnosed in 43.2% of small dogs and 61.3% of large dogs.
• Small dogs had lower prevalence of splenic hemorrhage and higher prevalence of hemorrhage from liver or from another location such as retroperitoneal mass, kidney, or adrenal vs large dogs.
• Hemangiosarcoma was associated with splenic hemorrhage and occurred more frequently in large vs small dogs

Question 9

Hatch, JAVMA 2018

• What was the incidence of chyloabdomen in cats and dogs? Differences?

Answer 9

• Incidence was 2.0 cases/100,000 admissions for cats and 2.8 cases/100,000 admissions for dogs.
• Mean age at dx of chyloabdomen in cats was 11.3 years, compared with 6.9 years in dogs.
• The most common c/s in dogs and cats combined were lethargy (39/51 [76%]) and anorexia (37/51 [73%]), but fewer (23/53 [43%]) had abdominal distention.
• Chylothorax was a common comorbidity (25/53 [47%]), with malignant neoplasia being the most common underlying diagnosis (24/53 [45%]).
• MST from diagnosis of chyloabdomen was 31 days overall (25 d for cats; 73 d for dogs), 8 days for patients with malignant neoplasia (carcinoma), and 73 days for patients without neoplasia.

Question 10

Marshall, JVECC 2019

• What was found in this septic peritonitis study?

Answer 10

• The likelihood of an aerobic organism to have multidrug resistance post-lavage was a third of that pre-lavage
  -39 of 40 dogs (97.5%) received appropriate empiric antimicrobial therapy based on pre- and post-lavage culture results, of which 5 (12.8%) did not survive to discharge.
• Most frequent isolates detected included Escherichia coli, Clostridium perfringens, and Enterococcus faecalis.
• The same organism based on species was isolated in pre- and post-lavage cultures in 32 dogs, accounting for
  59 anaerobic and aerobic isolates. There was a new bacterial isolate detected in 20 dogs, accounting
  for 46 isolates and an overall total decrease of 14 isolates between pre- and post-lavage culture
  -Overall survival rates (87.5%) were higher than previously reported in the literature for septic peritonitis (20-85%)

Question 11

Scotti, JVECC 2019

-What was found in cats with septic peritonitis (SP)?

Answer 11

• 58 survived to discharge (69.9%)
• The most common etiology was secondary SP due to GI perforation (49.4%), followed by primary SP (22.3%).
• Mean blood glucose concentration was significantly different between survivors and nonsurvivors
• Cats that received appropriate empirical antibiotic
  therapy were 4.4 times more likely to survive than cats that did not receive appropriate antibiotics